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Table of Contents
January-March 2016
Volume 11 | Issue 1
Page Nos. 1-25
Online since Thursday, March 10, 2016
Accessed 3,520 times.
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ORIGINAL ARTICLES
Umbilical cord abnormalities
p. 1
Elghazaly Abdulrahim Elghazaly, Qurashi M Ali, Haydar Hadi Babikir
DOI
:10.4103/1858-5000.178489
Objective:
Stillbirths and neonatal outcome after delivery has been associated with umbilical cord findings. Cord abnormalities may put the baby in higher risk of certain diseases or low birth weight. The etiology of the umbilical cord abnormalities are not clear diagnosis. Although the fetal mortality associated with umbilical cord abnormalities is very high, identification of the fetus at risk has remained a difficult problem. The aim of this academic work is to study the human umbilical cord (UC) congenital abnormalities including length, diameter, coiling pattern, and placental insertion site in full term Sudanese neonates.
Materials and Methods:
One thousand and twenty UC of full-term birth neonates of both sexes, single and twin, of normal vaginal delivery in 2013, were studied in the Department of Obstetrics and Gynecology, Omdurman Maternity Hospital. UC length was entirely measured in centimeters using flexible plastic meter and the diameter was measured by Vernier caliper. The number of UC coils, coils pattern, insertion site, knots, cysts, and the blood vessels were fully studied.
Results:
The average UC length was about 58 cm, with minimal difference between male to female, single to twin birth. In majority of the cases, true knots occur without any clinical significance, whereas the tight knot may impede the circulation and may lead to low birth or intrauterine death. Thin cord places fetus at risk during pregnancy and may result in restricted growth, low birth weight, and neonates which are small for gestational age. This appears to be a consequence of reduction in the area of Wharton's jelly or small cord diameter. Very helical designs may predispose the fetus to certain blood flow changes, and very straight designs may be susceptible to compression. In both these types of coils, the degree of coils vary depending on cord length, diameter, fetal gender, and number of pregnancy. Hypercoiled coils may predispose the fetus to certain blood flow changes and hypocoiled cords may lead to the fetus being susceptible to compression; however in both cases, the blood flow and fetal weight may be affected. These factors were considered regarding possible interactions and correlation to pregnancy and perinatal outcome.
Conclusion:
Average length of UC in Sudanese neonates about 55 cm, being long in males and single birth, and there is no big difference in the cord length measurement before and after birth, comparing the two methods (ultrasound and manual measurements). 20cm of the cord length is suitable for fetus to be delivered vaginally. Average UC diameter in Sudanese neonates about 1.5 cm, big in males and single birth, Maximum UC coils about 45 coils, more in males and single birth, eccentric insertion is more common than central or marginal false knots of the are also more common than true knots. Most of the cord true knots located near to the fetal end of the umbilical cord, and they were commonly coiled to the left side (anticlockwise direction) incidence of a SUA in Sudanese neonate about 1% more common in males
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Blood pressure changes among children living at high altitude in South-Western Saudi Arabia
p. 7
Humeda Suekit Humeda Mohammed Ahmed, Mohammed El-Habib Mohammed Khalid, Mansour Abdelgadir Ballal, Fahaid Hassan Al-Hashem
DOI
:10.4103/1858-5000.178491
Objective:
To determine the effect of high altitude on systemic blood pressure (BP) among children.
Subjects
and
Methods:
About 145 school children from high altitude and 155 from low altitude were included in this study. Measurements of normal BP, body weight and height, triceps skin fold, waist circumference, and hematocrit value were made. Body mass index (BMI) was calculated from body weight and height, and the percentage of fat mass (FMP) was calculated from triceps skin fold measurement.
Results:
There was no difference in the mean age for high altitude and low altitude groups (12.46 ± 1.56 12.41 ± 1.52, respectively). Body weight and height were significantly higher in high altitude children than their counterparts at low altitude. The mean BMI values were not significantly different between the two groups. Children living at high altitude had significant higher systolic blood pressure (SBP) and diastolic blood pressure (DBP), hematocrit value, triceps skin fold, waist circumference, and FMP than those living at low altitude. There were positive significant correlations between SBP and DBP on one hand and body weight and height, BMI, FMP, waist circumference, triceps skinfold, and hematocrit values on the other hand.
Conclusion:
The significant difference in BP between the two groups was attributed to high body weight and height, body fat, and hematocrit value in the high altitude group.
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A study on the electrocardiographic findings in acute stroke, a case controlled study in a tertiary hospital in Eastern India
p. 13
Abdullah Md. Hasan, Pradip Kumar Datta, Sudipta Saha, Mrinal Achariya, Niladri Sarkar, Rajeev Ranjan
DOI
:10.4103/1858-5000.178507
Context:
In cerebrovascular accident (CVA) patients, electrocardiogram (ECG) changes may or may not be due to underlying cardiac illness.
Aims:
This study was done on CVA patients without underlying cardiac illness and diabetes, to evaluate the incidence and patterns of ECG changes in acute stroke.
Settings and Design:
Prospective nonrandomized case-control study in a tertiary hospital.
Subjects and Methods:
Ninety-seven CVA patients as case and 97 patients' age and sex matched, attending preanasthetic check-up without cardiac illness and diabetes were taken as control. ECG computed tomography brain, magnetic resonance imaging brain (in inconclusive situations) were done.
Statistical Analysis Used:
Chi-square test and Levine test using appropriate software IBM SPSS Version 22.
Results:
Among 97 CVA subjects, 80 had hemorrhage and 17 had infarcts. 55 lesions were situated in the right hemisphere and 42 in the left hemisphere. ECG changes were present in 89.6% patients (87 of 97). Among control 22.6% (22 of 97) had new ECG changes (
P
< 0.01). The most common ECG changes were prolonged QT
c
interval (78/97) 80.4%, increased QT
c
dispersion (QT
cD
) (66/97) 71%, and ST-T changes (16/97) 16.5%. Hemorrhagic strokes had more QT
c
prolongation (71/80) (81%) than ischemic CVA (7/17) (41%) (
P
< 0.001) QT
cD
was more with hemorrhage (63/80 = 79%) than with ischemia (6/17 = 35.3%) (
P
< 0.001) QT
cD
increase had increased mortality (29/69 = 42%) than with no QT
cD
increase (1/28 = 3.5%) (
P
< 0.001). Ischemic CVA had more ST-T changes (8/17 = 47%) than hemorrhage (8/80 = 10%) (
P
< 0.01).
Conclusions:
This study showed increased incidence of ECG changes following CVA. QT
c
and QT
cD
prolongation were more in hemorrhagic CVA while ST-T changes were more in ischemic CVA. Increased QT
cD
were associated with increased short-term mortality.
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Characterization of normal lumbar spine in Sudanese population using magnetic resonance images
p. 19
Mazin Babikir Abdullah Hassib, Mohammad Elfadil Mohamed Garelnabi, Aida Abd Elkareem B Haraz
DOI
:10.4103/1858-5000.178508
Introduction:
Various medical imaging technique used in radiology to investigate the anatomy and physiology of the body in both health and disease. The main principle of magnetic resonance images (MRI) use strong magnetic field and radio waves to form an image for a certain area in the human body. The technique widely used in the hospital for medical diagnosis. In clinical practice, the MRI is employed for the assessment of lower back in the human body. Knowledge of lumbar the spine character is important for the clinical assessment of spine diseases.
Materials and Methods:
This study consisted Fifty nine consecutive patients gender both males and females Ages between 18-45 years adult with no known history of lumbar spine diseases underwent lumbar spine MRI sagittal T1, T2-weighted images. MRI machine 1.5 Tesla was used the selected sequences were Scout: axial sagittal, and coronal.
Objective:
The aims of this study were to establish a normal range of values for lumbar spine length (high) and classify the signal intensities by use of MRI for normal Sudanese adult with no known history of lumbar spine diseases.
Result:
Of this study revealed Correlation between measurement of the lumbar spine and body indices. The data were expressed as means ± standard deviation (S.D). Lumbar spine length (high) and signal intensity were analyzed as combine group (male + female) as well as the total sample. The data statistical analyses were performed using excel software programmed and statistical analyses were performed using the independent sample
t
-test, simple correlation (SPSS software version 20 USA) statistical significance was assumed at
P
< 0.05
. Conclusion:
The lumbar spine length (high) for Sudanese adult were found to be in the ranges of (13.8-23.4) cm with mean = 16.9 ± 1.7 S.D. the signal intensities for lumbar spine in MRI fast spin echo image (FSE) were found to be in the ranges (61-163) pixel value (45-110) pixel value for vertebrae and inter vertebral disc respectively.
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CASE REPORT
Hydatid cyst of the pancreas: A case report in the West of Iran
p. 23
Mazaher Ramezani, Hadi Yarahmadi, Masoud Sadeghi
DOI
:10.4103/1858-5000.178509
Echinococcus granulosus
is caused hydatid cyst disease that is a common parasitic disease in endemic region. In this study, we report our experience with a case of hydatid cyst involving the pancreas in the West of Iran. A 65-year-old woman admitted to our hospital with abdominal discomfort presenting for 4 months. Computed tomography scan revealed mass measuring 5 cm × 4 cm with increased wall thickness in the head of the pancreas. A cystic adenocarcinoma was included in the differential diagnosis. Tumor markers (carbohydrate antigen 19-9, carcinoembryonic antigen, and alpha-fetoprotein) had normal range. On abdominal exploration, whipple surgery was done. Histopathologic findings revealed a well-defined creamy-whitish mass measuring 6 cm × 4 cm × 3 cm attached to small intestine. The microscopic examination revealed a typical hydatid cyst which contained some scolices. After this case, we believe hydatid disease must be considered in the differential diagnosis of pancreatic cysts, especially in countries where echinococcosis is endemic. In this condition, use of specific antigenic tests can be helpful for preoperative diagnosis and appropriate management of the disease.
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